Itineraries for Preventing Altitude Sickness in Tibet

Did you know that most of the popular itineraries for travelers to Tibet — like the common tours that have you fly into Lhasa’s high elevation — put you at high risk of getting altitude sickness? In this post we give you examples of Tibet travel itineraries designed for preventing altitude sickness. (Plus one example of a really bad itinerary.)

You may not be able to entirely avoid getting altitude sickness, but we hope to help you make better choices so that you can get no more than mild symptoms.

The goal is to prevent dying or having to abandon your trip to due severe illness!

A high pass on the way from Gardze to Yarchen Gar in Kham.

In this post, you will find:

A popular trip to Lhasa that is an example of what NOT to do

Three examples of tours that are more helpful for preventing altitude sickness

Lhasa Highlights

Mount Everest Base Camp

Mount Kailash

A Highlights section with a few key points we think are important for you to take away from this post.

Example of What Not To Do

Here’s a super popular quick trip into Lhasa, in which the traveler flies in from somewhere near sea level in China, hits the main sites of Lhasa, and then takes a flight or train out.

It seems so quick and convenient, but this trip puts you at hideously high risk of getting altitude sickness!

In one day, you gain 3162 meters/10,375 feet in elevation. Not the way to do it!

Another thing to avoid in your first days at high altitude is significant physical exertion. Climbing the steps of the Potala is definitely a bit of a hike. Even walking around the major monasteries involves some little hills and stairs.

Within 24 hours of arriving, you visit the Potala Palace, which is a thirteen-story building that visitors basically hike up to the top of, to see the Dalai Lamas’ quarters. The top of the Potala is about 300 meters/1000 feet above Lhasa’s base elevation.

Within 48 hours or so of arriving, you visit Drepung Monastery, which is a bit higher than central Lhasa. If you want to enjoy the Drepung kora (prayer path around the monastery), you’ll reach an elevation of 3900 meters/12,795 feet.

Another bad example is the super popular Kathmandu to Lhasa overland trip (which has been closed since the 2015 earthquake).1

Good (or at least Better) Itineraries for Preventing Altitude Sickness

No itinerary is guaranteed to prevent altitude sickness, because every person has a unique genetic response to high altitude, but you can greatly lower your chance of getting altitude sickness by following an itinerary that ascends slowly.

For many reasons it’s very hard to follow slow ascent rules as you enter Tibet. You can’t do it perfectly, but you do it much better than most travelers currently do. Here are some samples of how.

#1 Sky Train and Lhasa Highlights via Xining

If you only have a very short time in Tibet, you could take the 7-day Sky Train and Highlights of Lhasa tour rather than the high-risk fly in to Lhasa. (To tell the truth, if you think you can only get to Tibet once in your life, it’s worth saving up the time and money to make a longer trip of at least two weeks.)

What’s Right with This Trip?

You take at least two days to reach 2700 m/9000 ft.

The first night is at 2275 m/7464 feet in Xining.

Though you are gaining a lot in elevation (over 1500 m and 5500 ft), it’s no problem because you are below the altitude at which altitude sickness symptoms generally develop in people who are susceptible, around 2500 m/8000 ft.

You have the easy option to spend more nights in Xining to acclimate even better. And you have time if you want to visit famous Kumbum Monastery and other local spots before your train leaves the next day.

For a significant part of the second night you are ascending from Xining (2200 m/7217 ft) to Golmud (2809 m/9216 ft) on the train. The train does go over some higher points along the way but all in all, this section of the route looks pretty good for acclimatizing. (After 2a to 3a, you will begin to ascend more rapidly.)

You arrive in Lhasa in the late afternoon, a perfect time to take it easy and rest.

You spend your first full day in Lhasa (day 4 of your trip) on activities that don’t take a lot out of you physically.

You save the straight-up staircases and ladders of the Potala for your last day :-)

Though not ideal, it is MUCH better than the four-day Lhasa itinerary in which you fly in.

What’s Not Ideal about this Trip?

Once you reach about 2500 m/8200 ft or so, you should not sleep the next night more than 500 m/1500 ft higher. Sadly, there is no practical intermediate stop once you’re on the train, and you need to continue on to Lhasa, which is 840 m/2760 ft higher than Golmud. (Not to mention that you are passing some extremely high elevations along the way.)

If not for this part of the journey, the whole trip could be considered low risk for getting altitude sickness. But due to the Golmud to Lhasa section, we suggest talking to your travel doctor about getting some altitude medicine for your journey.

#2 Everest Base Camp (EBC) Tour

This Everest Base Camp Tour gives you a relatively slow entry to Tibet, and allows a more reasonable path to Everest Base Camp than the 8-day trips which do it too quickly. (You will enter Tibet the same way as in itinerary #1 Lhasa Highlights via Xining by Train. See that itinerary above for more detail on the first 6 days of this trip.) (Update: There’s a new Easier Acclimatizing Everest Base Camp Tour offered by one of our favorite agents in Tibet now, which comes very close to the trip below :-)

Though not ideal, it is much better than flying in to Lhasa, and much better than some common Everest trips which go from Lhasa to EBC in only two days!

What’s Not Ideal About this Trip?

The Golmud to Lhasa section on the train on Day 3 ascends too high, too fast.

The elevation gain from Shekar to Everest Base Camp is 250 m/ 960 ft over the maximum suggested gain of 500 m/ 1500 ft. However, there are no reasonable alternatives that we can think of if you want to sleep at EBC. You might discuss just going up to EBC for the day with your travel agency.

#3 Mt. Kailash Trekking Tour

This trekking tour to Kailash combines all the positive elements of the Lhasa and EBC trips above, plus gives you an extra rest day before you hit the extreme high altitudes of Kailash. (See itineraries #1 and #2 above for more detail on the first 10 days of this trip.)

Highlights

The popular way of flying in for a 4-day Lhasa Highlights trip is a perfect example of what not to do if you wish to prevent altitude sickness.

Generally speaking, we recommend taking the train into Tibet rather than flying, and stopping at least one day in Xining along the way. (But note that simply taking the train is not an effective way to acclimate to Tibet’s high altitude.)

We recommend you save up time and money for your Tibet trip so that you can have enough days to acclimate better.

We recommend the taking the following number of days for these common trips, to allow for a relatively slow ascent:

Before you book a trip, carefully consider your itinerary in terms of lowering your risk for altitude sickness. We strongly encourage you to talk to your travel agent about this and let them know you want to follow the basic rules for avoiding altitude sickness as much as possible. If you need a referral for a high-quality Tibetan-owned agency – sign up for our Tibet travel service here.

And, as always, we want to remind you of these three simple, life-saving rules from the US CDC:

Never ascend to sleep at a higher altitude when experiencing symptoms of altitude illness, no matter how minor they seem.

Descend if the symptoms become worse while resting at the same altitude.

Conclusion

We would love it if slower ascents were the norm instead of the exception on popular Tibet tours. This is something that we are still learning about ourselves. At the moment, a few of the trips that we have featured on this site are not good examples of acclimatizing well.

We are working to change this, with this series on altitude sickness awareness, and by beginning to talk to the Tibetan travel agents we work with. Together we hope to create some new, more healthy, popular tours to Tibet. We’re still learning about the possibilities, and we welcome your input and suggestions!

From Losang at Land of Snows: “In my opinion, the trains that leave Xining later in the day, such as Z265 from Guangzhou (leaves Xining at 7:48pm) and Z165 from Shanghai (leaves Xining at 8:10pm) allow you to experience more of the high Tibetan Plateau during daylight hours.”

If you’re planning a trip to Lake Namtso while you’re in Lhasa, note that it is officially considered “very high” altitude at 4700 m/15,400 ft. Please don’t plan to drive from Lhasa and sleep at Namtso. We did it and had a wretched night. Talk to your agent about ways to do it more gradually, or to go up for just the day.

From Losang at the Land of Snows: “If you are having problems breathing at EBC, it is highly recommended that you descend to lower elevation. The small villages of Basum and Tashi Dzom (4155 m / 13,635 ft)are only a short drive away and are nearly 1000 meters/3280 feet lower than EBC. “

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Comments

I found all this very informative. Some years ago I joined with a small group in Kathmandu to go to Lhassa by jeep. We had a horrible overnight stay at a filthy “hotel” in some village. At one point we all had to get out and scramble, as well as we could, through thick brush up a vertiginous (to me, anyway, subject to fear of heights!) hill that almost finished several of us. Once in Lhassa, no particular rest for altitude acclimatation and climbing all the steps for the visits was hard, having to stop to catch breath after every 4 steps or so. The return by air was catastrophic… I was struck down with what I suppose was altitude sickness, to the utter dismay of the nuns who could be heard loudly praying for me! Finally they managed to get a doctor to come to the nunnery and I was “saved”!
Despite all that, I regret nothing and just remember how magical that visit was… despite the discomfort of insistent chinese presence and heavy-handed treatment of the Tibetan people…

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